CPT® Code 22534

Add-On Code

Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (List separately in addition to code for primary procedure)

Arthrodesis by lateral extracavitary technique, including minimal discectomy to prepare the interspace (other than for decompression), is a surgical procedure aimed at fusing vertebral segments in the thoracic or lumbar spine. This technique involves a lateral approach that necessitates the resection of ribs and exposure of the pleura and/or peritoneum, which is critical for accessing the targeted vertebral segments. The procedure begins with a midline incision that is extended laterally, allowing the surgeon to expose the paraspinous muscle bundle over the vertebral segment intended for fusion. The paraspinous muscles are carefully elevated off the spinous processes and laminae to provide a clear view of the underlying structures. During the operation, the paraspinous muscle bundle is divided and elevated off the ribs, followed by the dissection of the rib from the intercostal muscles and pleura. The rib is then resected, and the intercostal nerve is identified and protected to prevent any nerve damage. A high-speed drill is utilized to remove the associated transverse process and the lateral portion of the facet and pedicle, which exposes the dural sac and vertebral body. In cases involving the lumbar spine, the peritoneum is also exposed and retracted to enhance visibility of the vertebral body. The procedure includes the removal of degenerated disc material to prepare the interspace for arthrodesis, followed by the decortication of the vertebral endplates. To facilitate the interbody arthrodesis, a separately reportable bone allograft or autograft is placed between the vertebral endplates. After the necessary preparations and placements, drains may be inserted as needed, and the incisions are subsequently closed. This code, CPT® 22534, is specifically used to report the arthrodesis of each additional thoracic or lumbar vertebral segment, in conjunction with the primary procedure codes for thoracic and lumbar arthrodesis.